| NPI | 1063659605 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHERYL GOSNELL Executive Director 765-864-5900 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical (Licence: IN 080027811) |
| Enumeration Date | 2009-01-20 |
| Last Update Date | 2009-01-20 |